I’m sorry you’re going through this if you adamantly feel you are autistic, I never researched assessment prior I was just 100% myself and on pre assessment forms was just honest but I did get confused on few as you only know yourself so don’t really know what you perceive etc, I don’t collect anything or have any ‘special interests’ but i am very obsessive and maybe presumed special interests had to be things/ subjects, I apparently scored extremely high in every other aspect continuously throughout my life

Between the assessment and the feedback to your GP, they should be compiling a report and should be specifying what they think the problem is if you are not autistic.

In this window I most certainly would send them any additional information you think may have been overlooked.  They won't think you are making it up, you can just say that you are concerned some information might have been missing from the process and you are very keen to be reassured that whatever the answer is, it is the right one based on all the facts.

The diagnostic process isn't perfect and not all clinicians have their training uptodate.  There are three possible scenarios here:  a) you are autistic, but the clinicians have misunderstood something or did not have sufficient information, b) whilst it is nonsense that "everyone is a bit autistic" there are individuals who have an elevated number of traits but fall just short of a diagnosis as the criteria stand - you could be one of those c) your experiences are better explained by something else whether to do with mental health or the development of your brain, another form of neurodivergence, perhaps.

If the clinicians remain adamant that you aren't autistic, I would next ask them what they think is responsible for your characteristics and experiences.  Have a good look at that and see if with an open mind you think it fits.  If it doesn't, you may need a second opinion.

Just reopened 'Right to Choose' referrals, as per website. They were providing private assessments all along.

I think it pays to think about this ahead of the assessment. I had mine recently and we spent over an hour on the routines, habits, dealing with change section, and the assessor kept saying "it doesn't sound like this is a big issue for you." I was struggling to come up with occasions where I was stressed out by a change in routine because I have structured my life in such a way that those issues rarely come up. I think she was ready to diagnose me not autistic until we got onto the sensory section and I said, "oh by the way, I eat exactly the same foods every day."

You could also try to get a second assessment, either from Psychiatry UK or another provider.

It sounds like the OP is an existing patient of theirs, in which case there is no reason (besides, potentially, cost - as also flagged by Martin) why they should not follow up with further questions or info.

In respect of new Right to Choose referrals, Psychiatry UK re-opened their service last week.

These are the ICD-11 diagnostic requirements for an autism diagnosis:

Diagnostic Requirements

Essential (Required) Features:

• Persistent deficits in initiating and sustaining social communication and reciprocal social interactions that are outside the expected range of typical functioning given the individual’s age and level of intellectual development. Specific manifestations of these deficits vary according to chronological age, verbal and intellectual ability, and disorder severity. Manifestations may include limitations in the following:
  • Understanding of, interest in, or inappropriate responses to the verbal or non-verbal social communications of others.
  • Integration of spoken language with typical complimentary non-verbal cues, such as eye contact, gestures, facial expressions and body language. These non-verbal behaviours may also be reduced in frequency or intensity.
  • Understanding and use of language in social contexts and ability to initiate and sustain reciprocal social conversations.
  • Social awareness, leading to behaviour that is not appropriately modulated according to the social context.
  • Ability to imagine and respond to the feelings, emotional states, and attitudes of others.
  • Mutual sharing of interests.
  • Ability to make and sustain typical peer relationships.
• Persistent restricted, repetitive, and inflexible patterns of behaviour, interests, or activities that are clearly atypical or excessive for the individual’s age and sociocultural context. These may include:
  • Lack of adaptability to new experiences and circumstances, with associated distress, that can be evoked by trivial changes to a familiar environment or in response to unanticipated events.
  • Inflexible adherence to particular routines; for example, these may be geographic such as following familiar routes, or may require precise timing such as mealtimes or transport.
  • Excessive adherence to rules (e.g., when playing games).
  • Excessive and persistent ritualized patterns of behaviour (e.g., preoccupation with lining up or sorting objects in a particular way) that serve no apparent external purpose.
  • Repetitive and stereotyped motor movements, such as whole body movements (e.g., rocking), atypical gait (e.g., walking on tiptoes), unusual hand or finger movements and posturing. These behaviours are particularly common during early childhood.
  • Persistent preoccupation with one or more special interests, parts of objects, or specific types of stimuli (including media) or an unusually strong attachment to particular objects (excluding typical comforters).
  • Lifelong excessive and persistent hypersensitivity or hyposensitivity to sensory stimuli or unusual interest in a sensory stimulus, which may include actual or anticipated sounds, light, textures (especially clothing and food), odors and tastes, heat, cold, or pain.
• The onset of the disorder occurs during the developmental period, typically in early childhood, but characteristic symptoms may not become fully manifest until later, when social demands exceed limited capacities.
• The symptoms result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Some individuals with Autism Spectrum Disorder are able to function adequately in many contexts through exceptional effort, such that their deficits may not be apparent to others. A diagnosis of Autism Spectrum Disorder is still appropriate in such cases.

It appears that your assessor reached their conclusion because there wasn't sufficient evidence within the second category listed above. Presumably if you scored highly on the AQ50 you would have some of those behaviours but perhaps struggled to come up with sufficient examples when asked.

I can't see any harm in emailing the assessor with details of any examples you have subsequently thought of, outside of the pressured environment of the assessment. The assessment is not an examination and the people doing the assessment should have awareness that autistic people can struggle to answer on the spot. I am not sure what the outcome would be but at least you'll know you tried.

Some people trust that assessing clinicians will be omniscient, and come to the right conclusion. I am not so trusting and I looked through the autism diagnosis manuals and made damn sure that I ticked all the relevant boxes. I do not like leaving things to chance. Yes, I also am not particularly attached to routines, largely because I have realised that fulfilling routines gives far less advantages than the inevitable disruption of routines causes disadvantages. So, though routines suggest themselves to me all the time, I stamp on them ruthlessly. I think that for a diagnosis you have to show at least one of either unusual focus on restricted interests (special interests), or, repetitive behaviours (routines, stimming and sensory difficulties). If you did not show evidence of either of these types of behaviour, this will be why you were not diagnosed. The diagnostic manuals impose a tick-box scenario on assessors and if you miss a tick the clinician is obliged to withhold a diagnosis. It might be worth writing to Psych UK, though you might have to pay for a clinician to go over your additional material.

forget about psychiatryUK, they have closed their referrals.